Decision making on nutrition and hydration for cancer patients during terminal stage cause critical impacts toward patient's comfort and living quality. The management of nutrition is the main dilemma that arises in these final situations and has been the subject of intense debate over the last few decades.
To find the views of patients, families, and healthcare professionals related to how decisions are made when cancer patients are at terminal stage.
This systematic review used PRISMA strategy to search and used Critical Appraisal Skills Programme checklist to evaluate the papers.
All English papers through August 2020 that contained the view of the decision making at artificial nutrition and hydration with cancer patients, families, and healthcare professionals at terminal stage were included. Selected studies were independently reviewed, and data collaboratively synthesized into core themes.
Most of the terminal stage cancer patients and their families initially started the decision-making procesupport and processing the clinical guideline of decision making for healthcare professional is necessary.Open end-of-life communication is especially important within the patient-family unit of care and can positively affect their medical, psychological, and relational outcomes. Nevertheless, end-of-life discussions are often perceived as difficult and avoided.
To develop and validate the Difficulties in End-of-Life Discussions - Family Inventory (DEOLD-FI) to allow a systematic assessment of reasons why people shy away from end-of-life discussions.
Patients with advanced cancer were recruited and completed the DEOLD-FI and measures of avoidance of cancer communication, quality of life and distress, and the experienced difficulty as well as the occurrence of end-of-life discussions. Standard item analyses and an exploratory factor analysis were conducted. Construct validity was analysed through associations between the DEOLD-FI and the aforementioned measures.
Questionnaires were obtained from 112 participants (53% response rate; male 54%, mean age 64.9 years [range 33-94]). In the final 23-item version two factors were extracted 'emotional burden due to end-of-life discussions' (α=0.90) and "negative attitudes towards end-of-life discussions" (α=0.91) explaining 69% of the variance (total scale α=0.93). Construct validity was supported by its significant correlations with the reported difficulty in end-of-life discussions (r=0.42) and avoidance of cancer communication (r=0.40 to r=0.46) and insignificant correlations with quality of life (r=-0.11), distress (r=0.16), and physical well-being (r=0.02). Those who had already engaged in end-of-life discussions showed significantly fewer communication barriers.
Results provide evidence that the DEOLD-FI is a valid and reliable instrument for the assessment of difficulties in end-of-life discussions. Benefits for clinical practice and research are discussed.
Results provide evidence that the DEOLD-FI is a valid and reliable instrument for the assessment of difficulties in end-of-life discussions. Benefits for clinical practice and research are discussed.Organizations such as Asia Pacific Hospice Palliative Care Network functions to promote quality palliative care development through training and education, research collaboration and variety relevant projects and events for all in the Asia and Pacific region.
To summarise and further compare existing development indicators used in Asia Pacific region for palliative care.
The current review used Whittemore and Knafl 's framework for integrative reviews. PubMed, Embase, CINAHL and Google Scholar databases were searched for eligible studies. This review focused on palliative care development according to the domains and indicators identified by the World Health Organization Public Health Strategy and ATLANTES Palliative Care Research Group. Joanna Briggs Institute critical appraisal checklists were adopted to assess the methodological quality of included studies.
Ten studies were included and two main findings were identified 1) There was a strong evidence of educational preparation, use of medicines andparts. The lack of details and documentation in the region and inadequate reporting measures impacts on the development of strong palliative care framework.Palliative care integration for patients with hematologic diseases has lagged behind solid-organ malignancies. Previous work has characterized hematologist perspectives, but less is known about palliative care physician views of this phenomenon.
To examine palliative care physician attitudes and beliefs regarding hematologic diseases, patient care, and collaboration.
A 44-item survey containing Likert and free-response items was mailed to 1000 AAHPM physician members. Sections explored respondent comfort with specific diagnoses, palliative care integration, relationships with hematologists, and hematology-specific patient care. Logistic regression models with generalized estimating equations were used to compare parallel Likert responses. Free responses were analyzed using thematic analysis.
The response rate was 55.5%. Respondents reported comfort managing symptoms in leukemia (84.0%), lymphoma (92.1%), multiple myeloma (92.9%), and following hematopoietic stem cell transplant (51.6%). Fewer expressepalliative care into hematologic care at large, echoing previous studies of hematologist perspectives. Palliative care physicians express enthusiasm for caring for these patients, desire for improved understanding of palliative care, and ongoing opportunities to improve hematology-specific knowledge and skills.Breakthrough pain (BTP) is common in cancer and other conditions yet there is a lack of validated BTP measurement tools.
We aimed to identify all tools assessing or characterising BTP in patients of any age with any condition, and to critically appraise their psychometric properties.
The Cochrane Library, PROSPERO, Embase, CINAHL, Medline, PsycINFO, Web of Science, Google Scholar, ProQuest, Evidence Search and OpenGrey were searched to identify all available tools used to assess BTP. A second search identified studies that had evaluated psychometric properties of tools identified in Search 1. Databases were searched from inception to November 2020. Studies were assessed using COSMIN criteria and GRADE guidelines.
Search 1 found 51 tools used to assess BTP. https://www.selleckchem.com/products/ag-221-enasidenib.html Search 2 found six tools that had a development study and/or a study evaluating a tool psychometric property. No tool had more than one study evaluating psychometric properties so a meta-analysis could not be conducted. Studies were of inadequate to very good quality.